"Do Drugs Cause Addiction?": NO YES

Do Drugs Cause Addiction?
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[The following transcript is from debatesdebates, a nationally-broadcast public television show

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"Do Drugs Cause Addiction?," was taped on August 26, 1996. Show # 113. Please contact Mr.
Warren Steibel for permission to reproduce this transcript.
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"Do Drugs Cause Addiction?"

DebatesDebates Show # 113
Taped: August 26, 1996
NO YES
Thomas S. Szasz, M.D. Richard S. Shottenfeld, M.D.
Professor Psychiatry Emeritus Assoc. Prof. of Psychiatry
SUNY Health Science Yale University School of Med.
Syracuse, N.Y. New Haven, Conn.
Dr. George J. Alexander Professor Ernest Van den Haag

Professor of Law New York, N.Y.
University of Santa Clara
School of Law
Jeffrey A. Schaler, Ph.D. Anne Geller, M.D.

Adjunct Professor Smithers Addiction Center
School of Public Affairs New York, N.Y.
TIMEKEEPER - MARK NIX: Welcome to this week's debate:

Do Drugs Cause Addiction? Dr. Schottenfeld, will you start off
our debate?
DR. SCHOTTENFELD: I am a physician, an associate professor

of psychiatry and director of the Substance Abuse Treatment Unit
at Yale University School of Medicine. Do drugs cause addiction?
Absolutely. Drugs powerfully act on and change brain cells, nerve
cells in the brain's reward system. Drugs fool people into believing
and acting as if drugs are critical, the most important thing--more
important than food, their loved ones, their health, or their work.
In my practice I see the enormous pain and suffering caused by
addiction--to addicts, to their loved ones, and to society. And just
as society needs to fight cancer through a coordinated program of
prevention, including reducing exposure and through treatment
and research, we need to address public policies needed to reduce
substance abuse and addiction through a policy aimed at reducing
addiction, including reducing the allure of addiction, and through
research and treatment.
Page 1 of 28 pages
TIMEKEEPER: Thank you. Dr. Szasz, would you like to make

your introduction?
DR. SZASZ: I am professor of psychiatry emeritus at State

University in Syracuse. The question, "Do drugs cause
addiction?" is prima facie nonsensical. Addiction is a form of
behavior. Behavior is not caused; it has reasons. Drugs can no
more cause addiction than sex hormones or genitals can cause
perversions or sexual acts. Some drugs, when ingested--which
itself is a decision--some drugs make people feel in certain ways
which they like to repeat. If you want to call that an addiction,
which is already a value judgment, because there are many
behaviors which are now called addictions--for example,
smoking-- Nobody called Churchill or Roosevelt an addict.
Now they would be called nicotine addicts. So addiction is not
a descriptive term, it is a stigmatizing term which is culturally
conditioned. And it reflects not a property of the drug, but a
property of the culture. So in sum, drugs cannot cause addiction.
TIMEKEEPER: Thank you, Doctor. Dr. Schottenfeld, would you

like to introduce your first guest?
DR. SCHOTTENFELD: Yes. To my left is Professor Ernest van

den Haag. He's been trained in psychoanalysis and law. He's
retired as the John M. Olin Professor of Jurisprudence at Fordham
University, and as you will hear, there is some disparity and
divergence of opinion on our own panel.
DR. VAN DEN HAAG: Okay. I think almost anything can cause
addiction in the sense that it can form a habit which is hard to get
rid of, depending on how volitionally strong people are. Drugs can
cause addiction; so can my girlfriend. If I am deprived of her I
will be restless and suffer from insomnia, loss of appetite, all kinds
of things that being deprived of an addictive substance--because
it's not the substance that is addictive, it's you who wishes to
continue a habit that you have formed. Is my time up?
TIMEKEEPER: You're doing fine.
DR. VAN DEN HAAG: [laughing] I can go for a long time.

Okay. It is certainly true that some thins, say alcohol, are more
addictive than others. Other things are simply called addictive
because people don't like them. In general [bell] I don't know
how you could cure an addiction, and I think it's--
Page 2 of 28 pages
TIMEKEEPER: Oh, you've got your time now, so we'll move on

here. Dr. Szasz, will you introduce your first teammate?
DR. SZASZ: I'd like to introduce Professor George Alexander,

who teaches law at Santa Clara University in Santa Clara,
California.
MR. ALEXANDER: It's really difficult to improve on the

statements that have been made by my good friend and colleague,
Dr. Szasz, and now by Professor van den Haag, with which I
completely agree. Addiction is a nonsensical term because it is
simply descriptive--misdescriptive--of behavior. If it were a
sensible term, then I would also agree with the statement made by
Dr. Schottenfeld that drugs are addictive, but then my first addiction to
which I have to confess was milk. There was a time
when withdrawal of milk gave me all of the symptoms that are
typically described, but my parents carefully weaned me off that
addiction, and frankly, I am now cured and I can even have a glass
of milk without feeling that I've got to have another. So it is a
curable thing. And that, I think, is the question we really should be
asking. Is there behavior that can be altered? That's an important
question, whether drugs are addictive in this nonsensical way [bell] is
unimportant and misleading.
TIMEKEEPER: Thank you, Professor Alexander. Dr.

Schottenfeld, your last teammate.
DR. SCHOTTENFELD: Dr. Anne Geller is chief of the Smithers

Addiction Treatment Center and immediate past president of the
American Society for Addiction Medicine.
DR. GELLER: Addiction is a complex illness, and it consists of

three major components: One are the drugs, which produce
profound brain changes and are variously powerful. The second is
the host--in this case human beings, though it could be animals--which is
variously vulnerable. And the third is the environment,
which provides or does not provide ready access to drugs and
approval of their use.
TIMEKEEPER: Thank you. Dr. Szasz, your last teammate.
DR. SZASZ: I'd like to introduce Dr. Jeffrey Schaler, who

teaches at the Johns Hopkins and American Universities.
DR. SCHALER: Thank you. I think it's important to be clear

about several facts regarding addiction. One, of course drugs
Page 3 of 28 pages
cannot cause addiction, because drugs are inanimate objects, and if

one really, truly believed that drugs had the power to cause
addiction, of course we would consider such an individual to be
psychotic. And I don't believe that my colleagues here are
psychotic, so I suspect that to defend the notion that drugs could
cause addiction is really a political trick or gimmick to effect a
particular style of social control. I think it's also important to
differentiate between how drugs get into the body and what drugs
do to the body. What drugs do to the body is relatively
uncontroversial. The controversy here is how do drugs get into the
body? And of course, people choose to use drugs. Thirty-five
years of research testing the notion of loss of control has always
shown that
people use drugs--heroin, cocaine, and alcohol--for psychological
reasons, not for physiological reasons, or in such a way as could be
caused by the power of the drug. [bell] Thank you.
TIMEKEEPER: Thank you. Dr. Szasz, would you mind

standing up and let's begin the questioning of the debate. Dr.
Schottenfeld, your team may begin.
DR. SCHOTTENFELD: Dr. Szasz, I thought I might start and

then ask-- Do you think there is any role for society or government
to play in improving public health, what type of roles, and-- For
example, do you think the government should attempt to regulate
or limit exposure to clearly toxic substances or carcinogens?
DR. SZASZ: The government has a role in informing and

protecting people from harmful substances--for example,
explosives, which are chemicals, and it has a role in regulating the
purity and truth of representing what a drug is that a consumer
would purchase. Beyond that, I do not believe government has a
role in protecting adults from themselves, which is a key issue in
the debate about drugs.
DR. SCHOTTENFELD: Let me follow up just by a question

about how you think about and would respond to an addict who,
for instance, has neglected his children and is now desperate to
overcome addiction and become a good parent? Do you think that
treatment should be made available to that person? Do you think
that society should conduct research to improve drug abuse
treatment and to make treatment available?
DR. SZASZ: Well, you are asking many, many questions:

whether or not it is a function of the government to provide
treatment for diseases which are bona fide diseases, and then to
Page 4 of 28 pages
provide treatment for what are not diseases but are politically
defined as diseases. It's difficult for me to discuss this subject
without reminding people of the audience that masturbation, self
abuse, was for 200 years the leading psychiatric disease before it
was replaced by drug abuse. So these are not diseases. Now if this
person wants to stop using drugs, he should use the same economic
means to get treatment that he used to get the drugs, namely, he
should pay for it. If he wants it, he will pay for it. A characteristic
of so-called drug treatment today is that the people who get it
don't pay for it. They only pay for the drugs, not for the treatment.
DR. SCHOTTENFELD: While of course in some ways we may

disagree on some of the premises, I think that if people contract
illnesses as a result of, say, exposure to toxic substances, even if
they allowed themselves to be exposed, that they still would
require treatment. I'd like to open up for the next question.
DR. VAN DEN HAAG: Yes --
DR. SCHOTTENFELD: Who would like to ask the next

question, Dr. Geller or--
DR. GELLER: I would like to ask the next question. Inasmuch

as drug use starts way below the time that people could be
considered as adults--in fact, most people start their drug use of
drugs of addiction, whether it be nicotine, alcohol, or more illegal
drugs, during their teens, when they can't be considered as adults,
is there anything that you would consider appropriate to protect
these young, very vulnerable people from access to drugs?
DR. SZASZ: Yes, indeed. First of all, the first appropriate thing I
think government's duty is to leave adults alone. If your concern
is children, then the government should say if you want to smoke
or take heroin or anything else as an adult, as a competent adult,
then stay out of my life. After that, I would say that it would worry
Jefferson, not to mention Aristotle, the idea that it is the
government's job to protect children from taking toxic substances.
For thousands of years, and even today, when it comes to
household cleansers and toilet cleansers, which are all very toxic,
it is parents who have to protect the children. The government
does not assume--you don't hear either from Mr. Dole or Mr.
Clinton talk about protecting you from Clorox. But Clorox is
much more dangerous for children than marijuana.
DR. GELLER: I would disagree, and I think that--
Page 5 of 28 pages
DR. SZASZ: You disagree that drinking Clorox is--
DR. GELLER: Oh, that over the long haul, drug addiction causes
a great many more--
DR. SZASZ: But there is no drug addiction--
DR. GELLER: --problems for society.
DR. SZASZ: --we are talking about learning a habit. Drug

addiction is already a--
DR. GELLER: Whatever you call it, whether it's learning a habit
or not--
DR. SZASZ: That's very important.
DR. GELLER: --it results in--
DR. SZASZ: It's very important.
DR. GELLER: --incredible societal cost.
DR. SZASZ: That's not true. It's only if society defines it that
way.
DR. GELLER: And drinking Clorox is not--
DR. SZASZ: For hundreds of years, people have smoked. And

even in many parts of the world today, the government promotes it.
DR. GELLER: And 400,000 people--
DR. SZASZ: Our government--
DR. GELLER: --year die of nicotine addiction.
DR. SZASZ: Our country was founded on the growing and

exportation of tobacco. That's a historical fact. The fact that
tobacco is harmful has been known for hundreds of year; it was
not discovered by any surgeon general. The surgeon general
doesn't discover anything. He is a political mouthpiece. All this
is now part of our American scene that we are discussing, and to
medicalize it, as you are trying to do and is a popular trend, I think
is simply a politically ideological phenomenon like stigmatizing
blacks or Jews.
Page 6 of 28 pages
DR. GELLER: Oh, you should tell that to the people who are
dying from the results of their nicotine and alcohol addiction and
to the people whose children have been killed--
DR. SZASZ: Thirty million Americans have stopped smoking,

according to government statistics.
DR. GELLER: And many more are not able to.
DR. SZASZ: Not able to? Or not willing to? How can you tell the
difference?
DR. GELLER: It's very difficult.
DR. SZASZ: Not difficult at all.
DR. GELLER: But they can be helped to be willing or able,

whatever you want to call it--
DR. SZASZ: If they want to be helped. I have no objection to

helping people voluntarily. [bell]
TIMEKEEPER: It's difficult for me to stop this, but you may sit.
Dr. Schottenfeld, you can stand and your team can now question
Dr. Schottenfeld.
DR. SZASZ: Then perhaps we should begin with where we left

off. How do you justify government coercion of adults who take
drugs and whose drug-taking in no way interferes with their life, so
you have to test them to find out whether or not they take drugs?
Now explain that, please.
DR. SCHOTTENFELD: Well, first of all, most of the people

who I see and treat come to me because of the pain that drug
addiction is causing.
DR. SZASZ: Who is paying for their treatment?
DR. SCHOTTENFELD: Some pay me directly, some--
DR. SZASZ: What percentage pay you directly from their own
pockets?
DR. SCHOTTENFELD: It depends on the site. I see some

private patients, they pay me directly, some get insurance, and I
Page 7 of 28 pages
also work very much in the public treatment system that is very
much supported by public treatment dollars. And the people who
come--
DR. SZASZ: And they come voluntarily?
DR. SCHOTTENFELD: Many do. They come voluntarily, they

come because of the pain that--
DR. SZASZ: Let's just address-- Let's address the involuntary
section, because you are wriggling out of this issue.
DR. SCHOTTENFELD: Well, even the involuntary section,

many of the people who have come in initially involuntarily as
they have made the types of changes and have been able to give up
and move away from drugs are thankful for that intervention. And
what they have often experienced is what I said at the outset. The
drugs have fooled them. They have fooled them into thinking that
this is the way they get pleasure, this is what's important, this is
more important than anything else to them in their lives, and that is
in part a chemical fooling, it's the way drugs work on the brain, it
causes terrible problems. And when they are no longer fooled,
they're able to make enormous changes and feel often extremely
grateful that somebody--government, a family member, an
employer, a friend--helped push them into treatment.
DR. SZASZ: Let me only say that this sounds to me--and I don't
know if it sounds to you--very, very eerily similar to forcible
religious conversion. But I would like Professor Alexander to
continue.
MR. ALEXANDER: Thank you. I am just interested in where

you stop. You believe in government making our lives better, and
you point out that they will be thankful afterwards. Well, let's put
that aside. We have no data on how many are, how many aren't.
But suppose now I propose to you that the government tell you to
stop eating eggs and stop using white sugar and stop eating fatty
foods--not asking you to do it, but telling you to do it, with some
demonstration that your life would probably be better--and eat less,
maybe more me than you, but assume it anyway. Are these all
good things?
DR. SCHOTTENFELD: No, and I wouldn't call for the

government making those types of changes.
MR. ALEXANDER: But you're calling for the government to do

exactly that with respect to people who have made a choice at
Page 8 of 28 pages
some point to take drugs, presumably knowing all of the things

that you know, at least at some level.
DR. SCHOTTENFELD: Well, it's not clear that they know all
the things that I know at any level. As Dr. Geller has already said,
most of the people who become addicted to drugs start out using
drugs as children, adolescents. I don't think they are fully informed at
that point. I don't think they can imagine what life
will be like if they become addicted. I think they get swayed very
early on by what a friend, what a peer is doing, and make choices
that can be terrible for them.
MR. ALEXANDER: But if you're right about that, then it seems

to me the government has failed. It has failed in providing
adequate information. I don't believe that for a moment. But
shouldn't that be where we put our energy so that people
understand the consequence of their choice?
DR. SCHOTTENFELD: Well, I certainly think that's an

important role for government to play. I agree with you. The
government should make accurate information available. It should
do a lot of things to try to educate our citizenry broadly about what
are the risks and benefits of various types of behaviors, how to
avoid those risks. That's an important role. When it comes to
addiction, addiction to heroin and to cocaine, I think considering
the very clear problems that people experience as a result of their
being addicted to these drugs, government has other roles that it
needs to play.
MR. ALEXANDER: Let me, before you go on to them, ask you a

bit more about that. If you assumed, as I do, that the government
has spent tremendous amounts of money providing education, but
will spend whatever more you think it needs to educate people,
then explain to me, after that education, why the government has
any more of a role in keeping people from choosing drugs than in
keeping people from choosing alcohol, which it allows, or eggs or
fatty meat?
DR. SCHOTTENFELD: Well, I think that in part the role is

called for, considering the nature of the problem and the severity
of the problem. Government has a role to play [bell] in limiting
carcinogens, access and exposure to carcinogens, and it should
play that role. It's an important part of preventing cancer.
TIMEKEEPER: Thank you, Dr. Schottenfeld. Professor

Alexander, would you please stand and be prepared to be
Page 9 of 28 pages
questioned.
DR. VAN DEN HAAG: Am I doing--
TIMEKEEPER: You can. You can go ahead.
DR. VAN DEN HAAG: Okay.
MR. ALEXANDER: I hope we disagree enough to make this

interesting.
DR. VAN DEN HAAG: Well, yes, I am wondering. There is one

thing though that I agree with you, that it is not a disease. I think
that it's a habit, but a habit which may be very hard to get rid of.
Now this habit not only damages the individual, which is a choice
that's theirs, as you pointed out, but it does have some social
damage--for instance, the people who engage in this habit to a
strong degree may not be able to work and may have to be
supported, as it were, by society. Dr. Szasz pointed out correctly
that they ought to bear the cost of their own treatment. But most
of these people are not able to bear any costs, because they don't
make any money. So I am wondering how you would confront this
problem.
MR. ALEXANDER: A very interesting question, though a rather

broad one. What you're asking me to do is to solve the welfare
problem, and Congress has just demonstrated it's a hard one to
solve. People do create the problem--
DR. VAN DEN HAAG: I'm not asking you to--
MR. ALEXANDER: I think you are. Let me tell you why I think
you are. People create all sorts of problems, such as not making
themselves employable, which the government ultimately has to
solve in one way or another, and drugs are no different from that.
Lots of people can use drugs without becoming a government
liability, and as a general matter I reject the notion that because
any habit may ultimately make a person indigent or in need of
government help gives government a right for that reason to
intervene.
DR. VAN DEN HAAG: May I interrupt you?
MR. ALEXANDER: Please.
DR. VAN DEN HAAG: It seems to me that implicitly you have
Page 10 of 28 pages
conceded that government has an interest in keeping people

employable. Now go a step further: For a person to remain
employable, there are two factors involved. First, the volitional
factor: He must want to be employable. If he wants to go on
taking drugs instead of being employed, there is really nothing
much that can be done about it. But supposing he wants to, or at
least is neutral, he is willing to become employable, don't you
think that the government may play a role in helping him to
become employed? Let me just add: I don't believe there is any
treatment for drug taking, incidentally. It's volitional; a person
will take drugs if he wants to. And Dr. Schottenfeld says that in
some sense he is fooled into believing that it's pleasant. Well, you
know, you may be fooled once, but if you find out it's pleasant and
afterwards is unpleasant--
DR. SCHOTTENFELD: I wonder who he is answering the

question of, you or me?
MR. ALEXANDER: Well, I think he is -- I am about to point

out--
DR. VAN DEN HAAG: I am making a statement and hope that

you will have a comment--
MR. ALEXANDER: I am about to point out, I think he is asking

it of you, because he says, shouldn't the government be obliged
foolishly to spend its money doing something that can't be
accomplished? And I think I have an answer to that. I think no, it
spends enough of its money foolishly as it is and it shouldn't do
more of that, but most of all, let me point out that the answer to the
question doesn't answer the question that we're debating, because
it's a question of social policy to what extent the government
makes up for the needs of its citizens and one in which it is
conceivable that at an extreme Dr. Szasz and I may have slight
disagreement. But however you resolve the question of how much
government money ought to be used in providing something
useful, if one accepts your premise, that this treatment is useless,
then certainly that is not something that the government should do.
DR. VAN DEN HAAG: This treatment-- Forgive me, I don't

know--
DR. SCHOTTENFELD: Maybe we should have Dr. Geller shift

to at least perhaps a different view about whether treatment is
useless and some type of follow-up question.
Page 11 of 28 pages
DR. VAN DEN HAAG: I would like to try to define first of all
what we mean by treatment. If we mean by treatment an
educational effort to call attention to the damage that drugs
produce--
MR. ALEXANDER: Well, then I am all for it.
DR. GELLER: No, no, no--
MR. ALEXANDER: I said that.
DR. GELLER: --we don't mean that. We mean what we do--
DR. SCHOTTENFELD: But I think there is disagreement here

between what we might mean and what's important in treatment,
and maybe Dr. Geller would like to address that question.
DR. GELLER: I would like to ask you: Have you read the
treatment outcome data? Are you aware that there is considerable
scientific evidence that treatment in fact is effective for a certain
percentage of the people treated? Not all of them--
MR. ALEXANDER: Absolutely.
DR. GELLER: --but some of them.
MR. ALEXANDER: Absolutely I've read that. And some of it is

true, some of it is not.
DR. GELLER: Absolutely, so--
MR. ALEXANDER: But for the portion that is true, I welcome

the notion that voluntary people find means to take whatever help
they can get in changing their habits. I mean, I think people ought
to get help in exercising more too, and in eating better foods. I am
for all of that. [bell] I am simply not for dragging people off the
street to do it to them when they don't want to, and my reason is
exactly yours: It can't be done, it's a waste of money, and it is a
bad government policy.
TIMEKEEPER: Thank you. Professor van den Haag, would you

stand and be prepared to be questioned?
DR. VAN DEN HAAG: Whom am I asking?
TIMEKEEPER: Oh, they'll be asking you.
DR. VAN DEN HAAG: Okay. I'll answer anything. Not
Page 12 of 28 pages
necessarily correctly. [laughter]
DR. SCHALER: Professor van den Haag, it seems that you

view addiction as a volitional process now--
DR. VAN DEN HAAG: Yes.
DR. SCHALER: --and I suspect that what you may refer to as

treatment involves secular ethics, education, that type of thing,
through conversation, perhaps even moral confrontation with
oneself. How could involuntary treatment ever be justified?
DR. VAN DEN HAAG: Let me answer this simply. I am totally

opposed to involuntary treatment--
DR. SCHALER: Good. Good.
DR. VAN DEN HAAG: --because both I think it's morally

suspect and because I think it is totally useless. If a person wants
to drink, you can tell him 50 times, "You're an alcoholic; you must
change," and still if he wants to drink, he will drink. You can dry
him out, you can deprive him of alcohol or heroin or cocaine or
whatever, for awhile, but if he wants to go back and do it, he will
go back and do it. So the thing has to be voluntary. But I don't
feel-- When we speak of volition, we should keep in mind that it is
not a monistic, homogenous factor. A person may really in some
part of his personality wish to refrain from taking drugs in view of
undesirable consequences, but at the same time, not be able to
resist or feel unable to resist, or in fact not resist the temptation to
take the drug, even though he has told himself he will not take it.
Now it seems to me that as long as it is voluntary--and let me point
out, we haven't found a good method of doing so--but to the extent
to which we could do it, we should try to strengthen his volition
and try to give him the information that leads volition in the right
direction.
DR. SCHALER: May I add one thing to that question, please? I

am not sure which psychoanalytic organization has come out with
this position statement--it's one of the large ones that basically has
voted against insurance involvement in reimbursement for
psychoanalytic therapy, treatment, et cetera, because they view it
as intrusive and in violation of confidential relationship between
the analyst and the client. Along the lines of your view of what
constitutes treatment and what constitutes addiction and
understanding that you oppose involuntary "treatment," do you see
any role--
Page 13 of 28 pages
DR. VAN DEN HAAG: Let me--

DR. SCHALER: Let me finish one thing. Do you see any role for
government to support treatment in any capacity?
DR. VAN DEN HAAG: Yes, I do, a). And b) Let me point out I
am opposed to involuntary treatment of anything, including for
that matter cancer or whatever else.
DR. SCHALER: But state involvement in--
DR. VAN DEN HAAG: But treatment should always be

voluntary unless it--there are some exceptions, but very few--but
when you ask is there any role, there is a role for the government
to help people who are affected by cancer by making treatment
available if they can't afford it themselves in some form or other,
without going into the details. Now I would think that if I have the
impression that a person drinks or takes heroin or cocaine, et
cetera, and really would like to stop but needs some sort of
environmental reinforcement of his volition to do so, I would be
willing to provide that within limits, but it depends in the first
place, I have to be sure that the person has not been referred to me
by a court who says to him, go over to this treatment center and
then you don't have to go to jail. That would be useless, of course.
DR. SZASZ: But look, if I may say something, this discussion and
your comments certainly are premised on ignoring the fact that the
American government, instead of persecuting foreign enemies,
which used to be the duty of governments for thousands of years,
is now persecuting its own citizens in the name of drug abuse and
drug treatment. After all, the jails are full of people, for instance--
DR. VAN DEN HAAG: Well, I haven't gone into that because
that wasn't the question I was being asked.
DR. SZASZ: Well, but it's--
DR. VAN DEN HAAG: Forgive me, when you say prosecuting its
own citizens, the government always prosecutes people who break
its laws. If it has made a law, which you may oppose--
DR. SZASZ: But you are opposed to it. But you are opposed to it.
DR. VAN DEN HAAG: No, no, forgive me. I have not talked
about that. I am against involuntary treatment, but I am not
necessarily against punishment for people who break the law. I
Page 14 of 28 pages
may want to change the law or not; that's a different matter. But
meanwhile I don't regard it as persecution if a person is
prosecuted and punished for breaking a law with which you may
disagree or I may disagree. It's still a law.
MR. ALEXANDER: Forgive me. I just have to ask. Was it just

for the German government to enforce the law of 1930s Germany?
DR. VAN DEN HAAG: I didn't say these laws were just or that
any laws were just..
MR. ALEXANDER: No, no, but you said--
DR. VAN DEN HAAG: And you know, I haven't discussed it.
Forgive me, I have merely objected to Tom's insistence that--
MR. ALEXANDER: But was it not persecution in Germany?
DR. VAN DEN HAAG: --that the government punishes people

for breaking the law. It's persecuted--
TIMEKEEPER: Thank you, Professor. Dr. Schaler, will you

please stand? And you may begin questioning.
DR. SCHOTTENFELD: Dr. Geller.
DR. GELLER: Dr. Schaler, I am enormously concerned by the

direction in which this debate is going, because we seem to be
ignoring the fact that drugs cause very significant brain changes
when people ingest them, and that when people ingest them
repeatedly, the brain is changed and changed in a permanent
fashion. That change in the brain drives behavior. And I would be
interested to know what you think about addiction as a driven
behavior caused by the drugs that the addict has ingested.
DR. SCHALER: Well, first let me respond by saying there are

many different activities that people engage in through which
they can damage their brains, so certainly one could do that
through the use of drugs, but drugs aren't exclusive in that sense.
Right? For example, riding bicycles, skiing, doing all kinds of
activities; using chainsaws can cause enormous injuries. Now
with regard to the idea that somehow a change in the brain could
cause behavior, I would like to respond by asking you, how do
you reconcile 35 years of research testing the loss-of-control
hypothesis of alcoholism, the most extensive studies on cocaine
conducted at the Addiction Research Foundation in Canada,
and Lee Robins*, the epidemiologist Lee Robins' study, the largest
Page 15 of 28 pages
study of confirmed heroin users--1973 Archives of

General Psychiatry. In each of these studies, the "alcoholics," cocaine
users, and heroin users were found to control their drug use
for reasons that were important to them. The presence of alcohol,
cocaine, or heroin had absolutely nothing to do with it. Now
these are confirmed studies in reputable journals. Never has the
loss-of-control theory, which underlies your question--certainly
the loss-of-control theory of addiction, which came out of
alcoholism in the temperance movement--it has never been held up,
it has always been found to be false, a myth. So I don't see any
evidence that shows that a change in the brain, which has yet to have
been identified, it is only hypothesized--can be shown to cause
behavior. It has never been shown. The opposite is true.
DR. SCHOTTENFELD: Well, that is always a complex issue,

and there may be multiple factors involved in affecting behavior,
causing behavior, and changing behavior. There are ways in
which things that can be caused by physical, biological impact of,
say, drugs and reward systems, might also be affected and
remediated by talking, by social influences. Cause is a complex
issue, and we shouldn't--you know--we shouldn't make it less so.
The question--
DR. SCHALER: But the research has--
DR. SCHOTTENFELD: The question--
DR. SCHALER: --consistently shown--
DR. SCHOTTENFELD: The question that--
DR. SCHALER: --that what people believe about the power of

drugs and the environment--
DR. SCHOTTENFELD: I was wondering about the research in

your--
DR. GELLER: I --
DR. SCHOTTENFELD: I was wondering about the research and

some of the research that now really looks at the impact of drugs
on specific brain cells, on the changes that occur there, either in
the whole systems of the brain and how that gets affected and
remains affected for prolonged periods of time, the reward system,
the limbic system, and on individual brain cells that are
permanently changed. You know, there is research that shows the
Page 16 of 28 pages
genetic changes that occur, the expression at the level of the gene,
of proteins that occur from drug abuse, and I was wondering how
you--
DR. SCHALER: Well, I would like to go back--
DR. SCHOTTENFELD: --incorporate in that your view that

drugs don't cause--
DR. SCHALER: --to my original statement, because to me this

type of argument is really a red herring. We differentiate between
how drugs get into the body and what drugs do to the body. What
you're saying is: How do you explain these changes in the body
that cause through the actual chemical interaction of the drug and
physiology? That's relatively uncontroversial. The issue here is
how does the drug get into the body? And it sounds like what you
are saying is the change in the brain causes the person to take the
drug which gets into the body. No, there is no evidence to show
that at all. Certainly there can be changes in the body and the
brain through the use of drugs--through drinking coffee.
DR. GELLER: Do you believe there is a difference between why

people initially use drugs--why some of the people who use drugs
seem to be unable to stop using them, and why adults who have
been exposed to drugs as children seem to be unable to control
their drug use?
DR. SCHALER: That they may seem to be unable is one thing. I

don't believe they are unable [bell] because if you ask every
person who was a heavy drug user how they stopped, they said
they wanted to stop. They stopped because they decided to stop. [bell]
TIMEKEEPER: Thank you, Dr. Schaler. Dr. Geller, if you don't

mind standing up and preparing to be questioned. Anyone can
jump in--
DR. SZASZ: How can you distinguish between whether

somebody-- I mean, you are confronted by another adult-- Now
your premise and the premise of the drug treatment ideology is that the
person can't control himself. Well then, how come he is
allowed to vote? How come he is allowed to vote? How come he
is allowed to drive a car? How can he control everything else in
his life except this thing?
DR. GELLER: That is--
Page 17 of 28 pages
DR. SZASZ: He controls his bladder, his bowels, I mean, his--
DR. GELLER: That is really remarkable, and in fact, one of the

things that's characteristic of many, many people who are addicted is that
they have enormous will power and ability to control all kinds of other
behaviors. But where the drug is concerned, the drug has produced, I
believe, changes in the brain which makes their ability to control that
particular piece of behavior exceedingly difficult, and in the presence of
the drug, often impossible.
DR. SZASZ: Well then how do you explain the fact that when a
person like this is treated in the old-fashioned, brutal way, and
simply put in prison for two months, cold turkey, then he comes
out and starts taking the drug again. Now he's free of the drug
effect.
DR. GELLER: Oh, he's free, but his brain has changed. I mean,
I think that we all understand that--
DR. SZASZ: So now you are saying that the brain--
DR. GELLER: --there are long-lasting effects in the brain after

using drugs. We can see physiological changes measurable--
DR. SZASZ: You can see physiological--
DR. GELLER: --occurring years after--
DR. SZASZ: One moment.
DR. GELLER: --addicts abuse drugs.
DR. SZASZ: Well, as Dr. Schaler has emphasized, you keep

wriggling out of this. There are physiological changes after you
box. You have minute hemorrhages in the brain. Well, is that
why you go back and box again or because you want to make more
money?
DR. GELLER: Well, no, but they are not the same kind of
changes. I mean, obviously some changes will--
DR. SZASZ: They are much more clearly demonstrable than the
changes you claim.
DR. GELLER: Oh, but the kind of changes you get from boxing
are going to possibly cause dementia or difficulty in cognitive
Page 18 of 28 pages
function, but they are not going to cause addiction, because they are not in
the same area of the brain.
DR. SZASZ: Well--
DR. GELLER: Why would you expect that?
DR. SZASZ: --I don't want to push this line of argument--
DR. GELLER: That's simplistic.
DR. SZASZ: --because it becomes silly, but in effect you are

saying there are two kinds of human beings, one that can't control
themselves, and the other, all the rest, that can. Well then, why
have blanket prohibition? Why prohibit drugs from all the others?
DR. GELLER: Oh, I think that one of the very interesting areas
of research is why some people appear to be more vulnerable to
drugs than others. And certainly we have a lot of research that
suggests--I think the data is convincing--that this is on a genetic
basis, not a simple gene, but a complex mode of inheritance which
makes some people more vulnerable to the effects of certain
substances.
MR. ALEXANDER: You seem to understand the many mysteries

that we don't understand, but why do you reject the much simpler
answer that people take drugs because they choose to take drugs?
If that's the cause, then it seems to me most of your efforts are
unfortunately misguided.
DR. GELLER: It seems to me that that's a kind of over-simplified

use of the word "choose." I don't know to what extent
an addict who is, for example, going through withdrawal and
feeling physiologically absolutely awful, chooses to use the drug.
I don't know to what extent someone who comes out of prison, for
example, and as you can measure, after two months, sees heroin or
sees his dealer and experiences profound physiological change.
I don't know what the meaning of the word "choose" is in that
instance. It's very different from someone choosing in other ways. [bell]
TIMEKEEPER: Thank you. It's time to move on to the next

round. Dr. Szasz, Dr. Schottenfeld, do you mind standing? Dr.
Schottenfeld, you can begin questioning Dr. Szasz.
DR. SCHOTTENFELD: Good. I thought maybe we could start by

exploring this issue about choice. And what I am thinking
about here is that we know that peer pressures, peer influences
Page 19 of 28 pages
powerfully are major factors leading young people to use. There

are surveys now, for instance, of California and New Jersey
students showing that 60-70 percent cite as a reason that they
don't use the fear of getting in trouble if they did use. So this issue
of choice, I would wonder whether you don't see it in part as being
in relation to what choices are available, what people are encouraged
to do by other people, by society, what countervailing influences
we develop.
DR. SZASZ: One question at a time. I am glad you asked this

question, because I have wanted to at some point bring up a very
simple consideration that Professor Alexander has pointed out, the
simplicity of maybe people choose to take drugs. For thousands
of years, and especially--this is especially important in the Jewish
and Christian tradition--people thought and believed that one of
the most important things in raising a child and growing up is resisting
temptation, saying no to certain things, abstaining from sex until
you can take care of your offspring, abstaining from peer pressure
not to study and instead to have pleasures, postpone gratification.
This is a choice that is available to everyone because it is simply
the choice to abstain from something. Now this is systematically
undermined by the medical and governmental ethos of, "You
poor thing. You can't help yourself. We'll take care of you."
DR. SCHOTTENFELD: But those choices, don't they also get

affected by the types of messages that we give? By--
DR. SZASZ: Yes, we give the message that you can't help
yourself.
DR. SCHOTTENFELD: --what society prescribes as smart

behavior, what it suggests people do?
DR. SZASZ: Absolutely.
DR. SCHOTTENFELD: So there are a variety of ways in which

society can and should influence the behavior to help people make
choices that will ultimately be in their best--
DR. SZASZ: But you are not speaking of the issue of temptation.
The way the government can influence the system is by letting
people be exposed to temptation and suffering the consequences as
early as possible. It's to do with raising a child and training him
how not to wet the bed, how not to eat all night.
DR. SCHOTTENFELD: But there are some consequences that I
Page 20 of 28 pages
think are too dangerous to let people experience, and drug

addiction is one. [bell]
DR. SZASZ: Then they will never control themselves.
TIMEKEEPER: Dr. Szasz, now you can go on the offensive.
DR. SCHOTTENFELD: I thought he was. [laughter]
TIMEKEEPER: It was almost like that, but don't sit down yet.
DR. SZASZ: Well, my offensive would be-- I mean, let me be

kind of nasty. Don't you think one could ask the question which
the Romans always asked in controversies: Cui bono? Who
benefits from this idea that, "You poor thing, you can't control
yourself?" You can control yourself, and you can control
yourself, but your patients can't. I find this ugly.
DR. SCHOTTENFELD: Again, I don't think the issue is who

can control themselves and who can't. I think that people, after
they get exposed to drugs, many people become addicted, and in
that process of becoming addicted, they no longer can control
themselves. They make decisions--they make decisions that are
not right for them. They are not right for them, they are not
right for society, and in that sense they have lost control of
themselves, and people again that I've treated and I've seen,
when somebody who has made the decision-- He is in the
midst of a cocaine binge, he's suffering chest pain from the
cocaine binge. What does he do, he stops using for a couple of
minutes until the chest pain goes away, and then he goes and
gets more cocaine. I don't think that indicates great control, and
I know in talking to many people like that, who have experienced
that, that they are much happier and feel much more in control
when they are no longer addicted.
DR. SZASZ: Well, I don't know if you have read and whether
you trust a book like Malcolm X's Autobiography of Malcolm X,
which describes how he was unable to get off drugs with all the
treatment systems, but got off it when he decided to get off it.
And that he said that getting off cigarettes was much harder than
getting off cocaine or heroin. I trust that kind of an account much
more than the professionally prejudiced accounts, all of which
profit economically from this enormous government-funded
industry called drug treatment.
DR. SCHOTTENFELD: I agree with part of what you are saying
Page 21 of 28 pages
in that there are many ways that people can come off drugs, and
Malcolm X demonstrates one of them. [bell] People can come
off in other ways too. Medical treatment is very effective as a
way of helping--
DR. SZASZ: Then would you have any objection to-- [bell]
DR. SCHOTTENFELD: --people come off drugs.
DR. SZASZ: --getting the government out of the medical

treatment--
TIMEKEEPER: Thanks, Dr. Szasz, we're going to have to hold

you back now. Professor Alexander and Professor van den Haag,
if you don't mind standing up, and you may begin to question
Professor van den Haag.
MR. ALEXANDER: Thank you. I think it's wonderful because

we have really shared a lot of agreement and we come to the point
of disagreement. You seemed to assert a few minutes ago that
you thought people could not be persecuted when the government
simply insisted that the laws be followed, but I know you don't
mean that. I just want you to tell me you don't mean that, because
then I want to ask you about the justification for the laws we have.
DR. VAN DEN HAAG: Well, that's largely a semantic matter.

All I wanted to say is that all governments, whether they are
legitimate or not, prosecute people who do not obey their laws.
It's a wholly--
MR. ALEXANDER: But if the laws are bad--
DR. VAN DEN HAAG: Wait a moment.
MR. ALEXANDER: Yes.
DR. VAN DEN HAAG: It's a wholly different matter whether the
government is legitimate, whether its laws are legitimate, whether
you want to obey them, whether you think morally it's better not
to obey them-- That's not what I was discussing. I was discussing--
MR. ALEXANDER: We were just quarreling about "persecute."
DR. VAN DEN HAAG: Right. And let me point out--I want to
quarrel just a little bit more semantically, because I don't think we
are all that-- intellectually at least--divided. I do totally agree that
Page 22 of 28 pages
people can, if they want to, control themselves. And that when
they say "I can't," they generally mean, "I am unwilling to,"
despite the fact that you call to their attention that they should, et
cetera, et cetera. But I think you go a little too far. You see,
people's volition, what they want, can be influenced by other
people. Not compelled--I am totally opposed to that; it doesn't
work. But you can influence them. You can, for instance, try to
change the atmosphere of the young in such a way that--
MR. ALEXANDER: Forgive me. I see where you are going, and
we probably agree on a good part of it. Let me get to something
on which we disagree. Since we both agree that taking drugs is a
volitional matter and we both agree that it is illegitimate for
government normally to change choices legitimately made, why
are you for criminalizing the use of drugs?
DR. VAN DEN HAAG: It is illegitimate to change choices, I

agree with you, but not necessarily to influence choices. Now I
think criminalization has in the United States in the whole not had
the effect of making drugs unavailable. [bell]
MR. ALEXANDER: No, it has filled our jails.
DR. VAN DEN HAAG: The major effect has been to--
TIMEKEEPER: Mr. van den Haag, you can start questioning

now. We're starting your time.
DR. VAN DEN HAAG: Okay. This is part of a question: Don't

you agree that the major effect of the law has been to cause the
prices of drugs to be higher than they would be otherwise?
MR. ALEXANDER: Exactly the point I was trying to make.

DR. VAN DEN HAAG: --and making it therefore a little bit more
difficult to use--
MR. ALEXANDER: No. More attractive to get into the drug

business and filling our jails.
DR. VAN DEN HAAG: Yes, I totally agree with you. More
attractive to get into the business, but the price is higher. And the
price being higher, less of it will be consumed. And if a
government's intention is to reduce the consumption, this is one
way of achieving it.
MR. ALEXANDER: And if you say that although you can't
Page 23 of 28 pages
really explain that the matter isn't volitional, it makes sense for
the government to fill half of its prisons and jails with people
who are there because the government is trying to dissuade
a few from taking drugs, that sounds fairly nonsensical.
DR. VAN DEN HAAG: Forgive me. People are there

voluntarily. They are there because they choose to do what has
been forbidden, knowing full well that if caught and convicted
they will be punished. So this is a choice.
MR. ALEXANDER: So the government--
DR. VAN DEN HAAG: Now if you like drugs so much that you
are willing to take the risk to go to prison for them, et cetera, then--
MR. ALEXANDER: Let me restate your point. The government

had two options and both options had to do with changing people's
choices. They could change people's choices a little bit to take drugs,
and they could change people's choices a lot about
committing criminal acts, and they chose to change people's
choices about committing acts in order to achieve the small
objective of encouraging a few people not to take drugs. That's a
pretty heavy price
DR. VAN DEN HAAG: I am not sure that I follow you fully, but
let me point out that there are good reasons why the taking of
drugs is socially undesirable. Not to the point necessarily of
saying that the people who do it can't help it or anything like that.
I think they can help it, but I think the government has a right to
discourage this. I think the majority of the American people
would like it to be discouraged because they are aware of the fact
that people who do take drugs become in many ways socially
undesirable. [bell]
TIMEKEEPER: Thank you, gentlemen. Dr. Schaler, Dr. Geller,

if you don't mind standing. Ladies first, and you may start
questioning.
DR. GELLER: I'm, again, a little concerned about the direction

we're taking when we talk about volition, because my concern, as
I have emphasized before, is with the introduction to drugs for
young people, since that's where most of the introduction occurs.
And I would be very interested to know how you would view any
kind of governmental intervention in making drugs less available
to young people, where addiction, as I see it, begins.
Page 24 of 28 pages
DR. SCHALER: Well, it's a difficult, and certainly an

arbitrary decision where to draw the line in terms of access even
for alcohol. I think that we should be consistent in our public
policies insofar that we allow and even require that someone die
for his country, that same person should be capable of making a
decision as to whether he could drink or take drugs. So I'm for
and support a consistency in policy. If that age is 18 at which a
person can vote and can join and fight in the armed forces, then
certainly he can make a decision about--or her-- about consuming
alcohol and any other drugs. So from that point of view--
DR. GELLER: Most of my patients started their drug use much,

much younger. I am talking about eight, nine, 10.
DR. SCHALER: Well, most people who use drugs at a young

age mature out of drug use. That's a natural phenomenon. There
is plenty of research work that shows that maturing out is a
normal, natural recovery from alcoholism. To quote the title of a
book by George Vaillant, most people just move out of it. So I
don't really see a problem that you're describing there.
DR. GELLER: We aren't talking about most people. Most

people don't seem to be vulnerable to addiction.
DR. SCHALER: I don't see any people as vulnerable to addiction.

I don't see the person as a victim. And my concern is
that we are in fact reinforcing a helplessness and passivity by
continually defining the person that way. The person that you
label as an addict isn't suffering from a weak will. In fact, he or
she has an iron will. He chooses to use drugs no matter what. He
has a very strong will.
DR. GELLER: Yes, I want to say the objection that you are
having to "vulnerability," would you consider that some people are
not vulnerable to diabetes, to arthritis--
DR. SCHALER: Again--
DR. GELLER: --to any other chronic illness?
DR. SCHALER: But again, I think you are mixing categories

here, and this is really a red herring. Diabetes is not a moral
situation. It's a medical, physical illness. What we talk about in
terms of addiction--
Page 25 of 28 pages
DR. GELLER: I don't believe that drug addiction--
DR. SCHALER: --we're talking about--
DR. GELLER: --is a moral situation.
DR. SCHALER: --moral issues and we talk about values and

volition.
TIMEKEEPER: Dr. Schaler, you can now turn that around into
a question, if you like.
DR. SCHALER: Well, I would like to continue with this. Do

you see diabetes or cancer as based in morality in any way?
DR. GELLER: No, nor do I see addiction--
DR. SCHALER: Could a person--
DR. GELLER: --as based in morality.
DR. SCHALER: But how is it that people change and moderate

their use of 0.cocaine? How is it in these major studies on
loss of control and on cocaine, where people moderated their use
of cocaine for reasons that were important to them? If they were
so enslaved, how were they able to do this? How is it that 87
percent of these confirmed heroin users in Vietnam came back and
gave up heroin like that, with no problem with withdrawal, no
treatment, nothing. And when they were interviewed, they said,
"Because we don't need it to cope with the experience of life
here." These are existential, moral, ethical issues. They are not
medical, physiological, biological issues.
DR. GELLER: You are very different from myself. And I think
we differ on many aspects. You look different. You have a beard;
I don't have a beard. We differ also, I think, in our response to
drugs, and you may be much less vulnerable to the effect of
addictive drugs than I am. And I am not talking about the 87
percent of people, if that's indeed the correct number, who can
give up drugs without problem. I am talking about actually the 10-15 percent
of people who experience enormous difficulty in spite
of their desire to do so--patients who come to me saying, "Please
help me. I want to give up drugs, but I can't." And I think that
their pleas are genuine and their addiction is a part of their
particular physiological makeup.
Page 26 of 28 pages
DR. SCHALER: I think they are liars. They are not telling the
truth.
DR. GELLER: That, I think, is very easy to say about anyone,

but I don't see it with my patients. I see them struggling, I see
them really putting a great deal of effort, and I see them very often
not being able to sustain it.
DR. SCHALER: In these other studies on loss of control with

alcoholism, which I am sure you are familiar with, how is it that
these people, labeled as the most chronic alcoholics, the people
who are most vulnerable, according to your definition of this
particular segment of the population-- These were the worst-case
scenarios. How is it that these people were able to moderate their
drinking because of what they believed was in the substance. for
example, they thought there was alcohol in a drink and there was
no alcohol in a drink; or they thought there was no alcohol in a
drink and there was alcohol. What they believed about each
substance was the best predictor in terms of whether they would consume the
beverage or not. Those are psychological issues, they
don't have anything to do with biology. Your thesis about some
kind of biological vulnerability has never been upheld by the
research. How do you explain that?
DR. GELLER: That is not true that it has not been upheld by the
research. It depends what research you look at. There is
considerable research done by Mark Schochet, Henri Begleiter,
looking at differences in people who later become addicted or who
are sons and daughters of alcoholics.
DR. SCHALER: But never testing the loss of control

hypotheses.
DR. GELLER: That is a red herring. I am not interested in

whether or not the loss of control hypothesis as a way of
describing what happens to addicts is in fact true. What I am
interested in is are there in fact people who have differential
vulnerability to using drugs. [bell]
TIMEKEEPER: Thank you. Dr. Szasz, would you mind standing

and giving us your closing statement?
DR. SZASZ: Well, as many of us, including our opponents--some

of our opponents--agree that drugs do not cause addiction, in the
correct use of English, let me only say this in conclusion: Human
nature has not changed over thousands of years basically. The
Page 27 of 28 pages
human brain has not changed, and many of the chemicals that we
are now talking about have been around for a long time. How
come we are having this discussion today in 1996? And my
answer is because this has become convenient for both right-wing,
left-wing, and middle-wing governments in the Western world. As
they have run out of scapegoats, the foreign enemies, they are all
now running against drugs, and this is a convenient scapegoat and
therefore your whole discussion about brains and chemistry is
really beside the point. [bell]
TIMEKEEPER: Thank you, Dr. Szasz. Dr. Schottenfeld?
DR. SCHOTTENFELD: Thank you. Part of the reason that

Vietnam vets stopped heroin use when they returned to the United
States was because drugs--heroin--wasn't nearly as available to
them on their return. Questions have been raised about government
persecuting its own citizens through its drug policies.
Really drugs persecute people. The fundamental question for us as
a society is how we're going to best prevent and treat addiction,
how we are going to reduce that harm. We're on the verge of
making major advances in treatment and prevention. We are on
the verge of a cocaine vaccine, we're on the verge of specific
medications to treat cocaine abuse, we're making major
improvements in treatment. We shouldn't abandon our people,
our citizens, our families, and communities to addiction. We
should pursue treatment, prevention, and research relentlessly.
TIMEKEEPER: Thank you, Dr. Schottenfeld. That ends this

week's television debate. Next week a new debate. But the debate
continues on our Web site. The Web site is at www.
debatesdebates.com. That's www.debatesdebates.com. You will
be able to join an ongoing forum of our debates, as well as
download free transcripts of all our programs. E-mail us your
comments and suggestions, and check out our schedule for the
topics of upcoming debates. Once again, our address is
www.debatesdebates.com. That's www.debatesdebates.com
Copyright, Four Score & Ten Productions, Inc.
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"Do Drugs Cause Addiction?": NO YES

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Do Drugs Cause Addiction?

[The following transcript is from debatesdebates, a nationally-broadcast public television show

"Do Drugs Cause Addiction?"

Dr. George J. Alexander Professor Ernest Van den Haag

Jeffrey A. Schaler, Ph.D. Anne Geller, M.D.

TIMEKEEPER - MARK NIX: Welcome to this week's debate:

DR. SCHOTTENFELD: I am a physician, an associate professor

TIMEKEEPER: Thank you. Dr. Szasz, would you like to make

DR. SZASZ: I am professor of psychiatry emeritus at State

TIMEKEEPER: Thank you, Doctor. Dr. Schottenfeld, would you

DR. SCHOTTENFELD: Yes. To my left is Professor Ernest van

TIMEKEEPER: You're doing fine.

DR. VAN DEN HAAG: [laughing] I can go for a long time.

TIMEKEEPER: Oh, you've got your time now, so we'll move on

DR. SZASZ: I'd like to introduce Professor George Alexander,

MR. ALEXANDER: It's really difficult to improve on the

TIMEKEEPER: Thank you, Professor Alexander. Dr.

DR. SCHOTTENFELD: Dr. Anne Geller is chief of the Smithers

DR. GELLER: Addiction is a complex illness, and it consists of

TIMEKEEPER: Thank you. Dr. Szasz, your last teammate.

DR. SZASZ: I'd like to introduce Dr. Jeffrey Schaler, who

DR. SCHALER: Thank you. I think it's important to be clear

cannot cause addiction, because drugs are inanimate objects, and if

TIMEKEEPER: Thank you. Dr. Szasz, would you mind

DR. SCHOTTENFELD: Dr. Szasz, I thought I might start and

DR. SZASZ: The government has a role in informing and

DR. SCHOTTENFELD: Let me follow up just by a question

DR. SZASZ: Well, you are asking many, many questions:

DR. SCHOTTENFELD: While of course in some ways we may

DR. VAN DEN HAAG: Yes --

DR. SCHOTTENFELD: Who would like to ask the next

DR. GELLER: I would like to ask the next question. Inasmuch

DR. GELLER: I would disagree, and I think that--

DR. SZASZ: You disagree that drinking Clorox is--

DR. SZASZ: But there is no drug addiction--

DR. GELLER: --problems for society.

DR. SZASZ: --we are talking about learning a habit. Drug

DR. SZASZ: That's very important.

DR. GELLER: --it results in--

DR. SZASZ: It's very important.

DR. GELLER: --incredible societal cost.

DR. GELLER: And drinking Clorox is not--

DR. SZASZ: For hundreds of years, people have smoked. And

DR. GELLER: And 400,000 people--

DR. SZASZ: Our government--

DR. GELLER: --year die of nicotine addiction.

DR. SZASZ: Our country was founded on the growing and

DR. SZASZ: Thirty million Americans have stopped smoking,

DR. GELLER: And many more are not able to.

DR. GELLER: It's very difficult.

DR. SZASZ: Not difficult at all.

DR. GELLER: But they can be helped to be willing or able,

DR. SZASZ: If they want to be helped. I have no objection to

DR. SZASZ: Then perhaps we should begin with where we left

DR. SCHOTTENFELD: Well, first of all, most of the people

DR. SZASZ: Who is paying for their treatment?

DR. SCHOTTENFELD: Some pay me directly, some--

DR. SCHOTTENFELD: It depends on the site. I see some

DR. SZASZ: And they come voluntarily?

DR. SCHOTTENFELD: Many do. They come voluntarily, they

DR. SCHOTTENFELD: Well, even the involuntary section,

MR. ALEXANDER: Thank you. I am just interested in where

DR. SCHOTTENFELD: No, and I wouldn't call for the